When does vomiting indicate something more serious? What can you do when your tot can’t keep food or medication down?
1 Spitting up and vomiting are not the same thing.
It is common for babies to spit up some undigested milk after a feed, and this can occur many times, every day.
Also known as possetting, this type of re flux is harmless and may affect up to half of all newborns up to three months old, says Dr Dawn Lim, a consultant paediatrician at Kinder Clinic at Paragon Medical Centre.
The muscle at the end of your baby’s gullet may still be developing. That’s why milk can back up after a feed.
If your little darling is a “happy spitter” – that is, she looks well and continues to grow well – you need not be worried about these occasions, Dr Lim adds.
What’s not normal is when the re flux starts causing her distress. In real vomiting, you’ll notice that she throws up her stomach contents more forcefully. She may be ill if she is vomiting more forcefully than usual, looks generally unwell or has a fever, Dr Lim says.
2 It could be Gerd.
Frequent and more forceful spittingup that causes discomfort could be due to a more serious re flux condition known as Gerd (gastroesophageal re flux disease).
Unlike “happy spitters”, a Gerd baby may appear cranky and not grow well, no thanks to the large amounts of nutrients she loses from all that vomiting.
As the re flux irritates her gullet, she may arch her back while feeding and sometimes even refuse to drink as the milk causes her discomfort, Dr Lim says. Alert your baby’s doctor if you notice these symptoms.
Dr Lim suggests feeding your baby in smaller amounts but more frequently.
Burp her in between and after each feed.
After feeding, hold her upright for 15 to 20 minutes.
3 Vomiting after bumping her head?
It could be serious.
Call the doctor or head to the hospital if your baby vomits more than two or three times after bumping her head, the American Academy of Pediatrics advises.
She may need a thorough check-up to make sure the vomiting is not due to serious complications, such as bleeding in the brain, which can be fatal, says Dr Zaw Lwin, a consultant at the Department of Emergency Medicine at KK Women’s and Children’s Hospital.
Other head-injury red flags include weakness, confusion, problems with coordination, being unusually sleepy or unable to wake up at night.
4 Watch for dehydration.
A tummy bug is one of the most common reasons of vomiting in young children, Dr Lim says. This is usually accompanied by diarrhoea. In some cases, it may signal more serious illnesses like acute appendicitis, a brain infection or intestinal obstruction.
Whatever the cause, it is important to watch for signs of dehydration, which is dangerous in babies and very young kids.
You can tell that she isn’t getting enough fluids if she is not wetting as many diapers, her lips and tongue look parched, or her eyes look sunken, Dr Lim says. Her fontanelles (the soft spots on her head) may also appear sunken. Seek medical attention if she shows any of these signs.
Besides these red flags, you should also take her to see a doctor if vomiting is accompanied by: severe tummy pain (look for an inflated or tense belly, non-stop crying, squirming more than usual or pulling up legs) swollen belly blood or bile (vomit may look greenish-yellow) poor feeding.
5 Offer small amounts of fluids every 5 to 10 minutes.
It can be tough feeding your sick baby if she is retching every few minutes. But don’t stop offering fluids.
Instead of giving her a drink immediately after she vomits, let her stomach rest for at least 10 to 15 minutes, Dr Lim advises. Then offer a small teaspoonful of clear fluid for her to sip on, she adds.
Increase the amount every five to 10 minutes to keep her hydrated.
“Her stomach is likely to be irritated, so she might throw up again if you give her a drink immediately,” Dr Lim explains.
“With vomiting, there is a worry that she could choke on her own vomit, and get an infection if some of it goes into her lungs.” If you’re breastfeeding, continue to do so. The antibodies in breast milk help her immune system and fight against infections that cause vomiting.
Once the vomiting stops, you may start a soft diet and choice of fluids in small, frequent feeds. Most kids can resume eating solids within 24 hours after they have recovered from vomiting, says Dr Zaw.
6 Hold that repeat dose if Baby throws up 30 minutes after taking her medication.
Don’t repeat the dose if your child vomits 30 minutes after taking her medication, and there is no or little medicine in the matter that has been vomited, Dr Zaw says.
You risk overdosing her.
But you may do so if she throws up immediately after taking it and you’re sure that she has vomited all her medication, he adds.
When in doubt, always err on the side of caution, says Dr Wendy Sinnathamby, a paediatrician at Raffles Children’s Centre.
To prevent your nauseous kid from throwing up her medication, she suggests using a syringe and placing the medication near the back of the tongue. Aim for the back gum and inside of the cheek. This helps the medicine flow down the throat.
7 Take preventive measures.
If you’re using bottles and other feeding equipment, sterilise them before use – by boiling for at least five minutes, for example.
Dr Zaw advises sterilising feeding equipment until Baby is one year old, when milk feeds are replaced with more solids.
Two doses of the rotavirus vaccine before the age of six months are another preventive measure. Rotavirus is one of the more common viruses that can cause vomiting and diarrhoea in children, he adds.
